Rheum Chapter Notes (4.26.2024)
Dr. Jack Cush reviews this past week’s news and journal articles from RheumNow.com.
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Canary in a Coal Mine (4.19.2024)
Dr. Jack Cush reviews regulatory reports, news and novel journal articles - this week focusing on Sjogren's, ILD, Gout and Uveitis.
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Mental health in 1150 adolescents & young adults w/ juvenile idiopathic arthritis (age 15.6 yrs; Dz duration 7.2 yrs, 43% oligo-, 26% polyarthritis): 30% reported suicidal thoughts, 19% mod-severe depressive/anxious Sxs (moreso in Females OR 2.33) https://t.co/THW1IMqZpa https://t.co/IU2Kr3efYj
Dr. John Cush @RheumNow( View Tweet )
Seasonal Pathogens and Henoch-Schönlein Purpura
Epidemiologic studies of Henoch-Schönlein purpura (HSP) have suggested seasonal variation in occurrence rates (higher from September-April, lower in June-August), suggesting a role for infectious triggers. The importance of infection was recently shown with nonpharmaceutical interventions (
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Higher Rates of Childlessness in Rheumatic Diseases
A large Finnish population study shows that several rheumatic diseases may impair reproduction and pregnancy outcomes, with significantly higher rates of childlessness or fewer children overall for women.
A nationwide cohort study of 5 339 804 Finnish citizens, born 1964–1984,
MMWR: Vaccination and Multisystem Inflammatory Syndrome in Children
MIS-C is a rare but serious condition typically occurring 2–6 weeks after SARS-CoV-2 infection and characterized by fever and multiorgan involvement.
https://t.co/PN2MPQxqSR https://t.co/eIzB4pjner
Dr. John Cush @RheumNow( View Tweet )
JAK inhibitors maybe an option in refractory Juvenile Dermatomyositis. Metanalysis of 26 reports (195 pts) JDM Rx w/ JAKi (median 5 rys); most Rx w/ tofacitinib (57%), ruxolitinib(27%), baricitinib (15%), w/ Improvement in 90%, 69%, 93%, respectively. https://t.co/tfISYVtwUN https://t.co/zv88Vdy6c0
Dr. John Cush @RheumNow( View Tweet )
Ides of March (3.15.2024)
Dr. Jack Cush has advice for Caesar and the superstitious, and covers pregnancy, platelets, dialysis and vaccinations in Lupus.
Dutch study of 586 RA pts on bDMARDs found more nonserious infections (NSIE) (77/100PYs) than serious infx (SIE)(1.3/100Pys). Upper respiratory
MMWR: Vaccination and Multisystem Inflammatory Syndrome in Children
CDC
Multisystem inflammatory syndrome in children (MIS-C) is a rare but serious condition typically occurring 2–6 weeks after SARS-CoV-2 infection and characterized by fever and multiorgan involvement. The current MMWR report shows that MIS-C case numbers have decreased by 98% since 2021.
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Sniffles & Arthritis (3.1.2024)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Are these associations with infection, biomarkers and weather real or imaginary? Linked or luck? Causal or casual? You decide....
No clear link between weather & MSK symptoms
Sinusitis Linked to 40% Heightened Risk of Rheumatic Disease
EurekAlert!
The common inflammatory condition sinusitis is linked to a 40% heightened risk of a subsequent diagnosis of rheumatic disease, particularly in the 5 to 10 years preceding the start of symptoms, finds research published in the open access journal RMD Open.
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In 551 juvenile myositis pts, 36% had myositis assoc Abs (MAA); 13% had >1 MAA. MAA+ pts had more overlap dz (18 vs 6%, p<.001) & assoc w/ Raynauds (OR 2.44), ILD (OR 3.43), chronic Dz (OR 1.72), mortality (OR 3.76). # MAAs was assoc w/ mortality (OR 1.83) https://t.co/BXhasmel3Z
Dr. John Cush @RheumNow( View Tweet )
Adult vs Juvenile DM by @susanshenoi at #RWCS24 @RWCSmtg @RheumNow
Adults tend to have myalgia, arthralgia, raynauds vs kids with skin ulcerations and vasculopathy https://t.co/1DW2kJsLfa
Dr. Rachel Tate @uptoTate( View Tweet )
Dr. @susanshenoi reviews IIM in juveniles vs adults. Some highlights:
*IBM only in adults
*PM more common in adults
See picture for additional pearls
#RWCS24 @RWCSmtg @RheumNow https://t.co/onUEwkKXBN
Dr. Rachel Tate @uptoTate( View Tweet )
VITAL Info on Autoimmune Disease (2.9.2024)
Dr. Jack Cush reviews the journal reports from the past week on RheumNow.com. Highlights are summarized by three songs: "Stairway to Heaven", "You're No Good", and "How Long (has this been going on)".
Many #RA pts remain on Steroids despite b/tsDMARD use! Study 228 #RA pts
Best Treatments for COVID-Related MIS-C
The RECOVERY trial focused on pediatric MIS-C patients treated with immunomodulators and anti-cytokine therapy demonstrated the benefits of first-line therapy with intravenous methylprednisolone or second-line tocilizumab in children refractory to initial treatment. Neither IV
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Tic-Borne Disorders Causing Chronic Arthritis?
Findings from a population based cross-sectional study suggests that while up to 20% of patients have antibodies to tick-borne exposures, only a minority reported musculoskeletal symptoms.
Lyme disease is one of many tick-borne diseases (TBDs) that may include spotted fever
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SLE: A Mutated Gene and TLR7 Overexpression
EurekAlert!
A group of researchers lead by Min Ae Lee-Kirsch from the Department of Pediatrics, Medical Faculty, TUD Dresden University of Technology (Germany), studied four patients from two families who developed symptoms of SLE in the first years of life. As familial occurrence of SLE in young
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2023 Rheumatology Year in Review
Dr. Jack Cush reviews highlights, advances and hot topics in rheumatology from 2023 and the RheumNow website.
2023 was a year of growth and new horizons while returning to operational and practice standards (in care and education) established before the pandemic.
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StillsNow Podcast December 2023 - ACR23 Highlights
Dr. Jack Cush reviews selected AOSD & systemic JIA abstracts from the ACR 2023 Annual meeting held in San Diego, November 12th thru 16th.
Abstract 0761. EULAR / PreS Recommendations for the Diagnosis and Management of Systemic Juvenile Idiopathic Arthritis (sJIA) and
Best of 2023: EULAR/ACR Guidance on Haemophagocytic Lymphohistiocytosis/Macrophage Activation Syndrome
A EULAR/American College of Rheumatology task force has established evidence based, up-to-date guidance and expert opinion on the evaluation, management and monitoring of patients with Haemophagocytic lymphohistiocytosis (HLH) and macrophage activation syndrome (MAS), with the primary
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FDA Approves the first Actemra biosimilar- called tocilizumab-bavi (Tofidence) or BIIB800 (during development). This IV FORMULATION is approved for use in active RA, polyarticular JIA and systemic JIA. https://t.co/AJD4uOS9hz https://t.co/8bmyTUWyFs https://t.co/6IYjk0XUJq https://t.co/OfjdvJZciB
Links:
Dr. John Cush @RheumNow( View Tweet )
Is MTX Safe in the Elderly? (12.1.2023)
Dr. Jack Cush reviews this past week's news and journal reports from RheumNow.com. Good news is that nearly 99% of adult rheumatology positions matched! But the challenge is that 45% of pediatric fellowship programs and 39% of pediatric rheum slots were unfilled in the 2024 NRMP match.
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Do We Stop or Continue Treatment?
Remission had been a dream, an elusive concept. But then, with the introduction of biologics, conventional synthetic and targeted synthetic DMARDS, patients are able to live longer and with a better quality of life. While these therapeutics have been helpful, they are expensive and carry
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JAKi and TYK2i: What to use and when?
You can see that the JAKi/TYK2i have both approved or potential seropositive and seronegative indications. There are also improvements in PsO for the class and studies in CTDs. So, it is difficult to know which to choose.
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